| NPI | 1154943462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 38314) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA 30372) |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2020-05-09 |